S9562 prior authorization | Blue Cross Blue Shield Oklahoma

S9562, Home Injectable Therapy Palivizumab Or Other Monoclonal Antibody For Rsv Including Administrative Services Professional Pharmacy Services Care Coordination And All Necessary Supplies And Equipment (Drugs And Nursing Visits Coded Separately) Per Diem, is on the Blue Cross Blue Shield Oklahoma commercial prior authorization list. Not a coverage or referral decision.

Code: S9562
Description: Home Injectable Therapy Palivizumab Or Other Monoclonal Antibody For Rsv Including Administrative Services Professional Pharmacy Services Care Coordination And All Necessary Supplies And Equipment (Drugs And Nursing Visits Coded Separately) Per Diem
Source: 2026 Commercial Outpatient Medical Surgical ASO Prior Authorization Codes, Pg 226 Original policy

Blue Cross Blue Shield Oklahoma prior authorization

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